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Vancomycin Pharmacokinetics

Vancomycin Pharmacokinetics Abstract Sir.—I recently reviewed the article by Naqvi et al,1 "Vancomycin Pharmacokinetics in Small, Seriously Ill Infants." In their analysis of serum vancomycin levels, the authors employed a one-compartment model using the equations of Sawchuk and Zaske.2 This technique of calculating the elimination rate constant, volume of distribution, and clearance will be in error when the drug exhibits multicompartment characteristics.3 Vancomycin has been shown to follow a biexponential decline in serum concentrations following intravenous administration in both adults and children.4,5 Naqvi et al sampled peak vancomycin concentrations immediately following a 60-minute infusion. Based on data reported by Schaad et al,5 which indicated distribution half-lives in infants of 0.05 to 0.5 hours, a significant amount of vancomycin may be in the central compartment at the end of the infusion.5 At this time point, serum concentrations are rapidly falling in the central compartment due to both References 1. Naqvi SH, Keenan WJ, Reichley RM, et al: Vancomycin pharmacokinetics in small, seriously ill infants . AJDC 1986;140:107-110. 2. Sawchuk RJ, Zaske DE: Pharmacokinetics of dosing regimens which utilize multiple intravenous infusions: Gentamicin in burn patients . J Pharmacokinet Biopharm 1976;4:183-195.Crossref 3. Riegelman S, Loo JCK, Rowland M: Shortcomings in pharmacokinetic analysis by conceiving the body to exhibit properties of a single compartment . J Pharm Sci 1968;57:117-123.Crossref 4. Krogstad DJ, Moellering RC Jr, Greenblatt DJ: Single dose kinetics of intravenous vancomycin . J Clin Pharmacol 1980;20:197-201.Crossref 5. Schaad UB, McCracken GH Jr, Nelson JD: Clinical pharmacology and efficacy of vancomycin in pediatric patients . J Pediatr 1980;96:119-126.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1986.02140250022015
Publisher site
See Article on Publisher Site

Abstract

Abstract Sir.—I recently reviewed the article by Naqvi et al,1 "Vancomycin Pharmacokinetics in Small, Seriously Ill Infants." In their analysis of serum vancomycin levels, the authors employed a one-compartment model using the equations of Sawchuk and Zaske.2 This technique of calculating the elimination rate constant, volume of distribution, and clearance will be in error when the drug exhibits multicompartment characteristics.3 Vancomycin has been shown to follow a biexponential decline in serum concentrations following intravenous administration in both adults and children.4,5 Naqvi et al sampled peak vancomycin concentrations immediately following a 60-minute infusion. Based on data reported by Schaad et al,5 which indicated distribution half-lives in infants of 0.05 to 0.5 hours, a significant amount of vancomycin may be in the central compartment at the end of the infusion.5 At this time point, serum concentrations are rapidly falling in the central compartment due to both References 1. Naqvi SH, Keenan WJ, Reichley RM, et al: Vancomycin pharmacokinetics in small, seriously ill infants . AJDC 1986;140:107-110. 2. Sawchuk RJ, Zaske DE: Pharmacokinetics of dosing regimens which utilize multiple intravenous infusions: Gentamicin in burn patients . J Pharmacokinet Biopharm 1976;4:183-195.Crossref 3. Riegelman S, Loo JCK, Rowland M: Shortcomings in pharmacokinetic analysis by conceiving the body to exhibit properties of a single compartment . J Pharm Sci 1968;57:117-123.Crossref 4. Krogstad DJ, Moellering RC Jr, Greenblatt DJ: Single dose kinetics of intravenous vancomycin . J Clin Pharmacol 1980;20:197-201.Crossref 5. Schaad UB, McCracken GH Jr, Nelson JD: Clinical pharmacology and efficacy of vancomycin in pediatric patients . J Pediatr 1980;96:119-126.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Nov 1, 1986

References